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G300 Ufe. Great Service <br />.1141111114NIT OP .V.1,116. <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2201001023-9 Pages: 1 <br />Debtor Name CARLOS BERMUDEZ <br />Filing Date and Time: 01/20/2022 11:07 AM <br />20220053'L <br />State Tax Lien — Statement of Continuation or <br />Termination; Certificate of Partial Release <br />or Subordination <br />Pursuant to the revenue laws of the State of Nebraska, the <br />Tax Commissioner hereby gives notice that the State Tax Lien <br />against the taxpayer identified below, the original notice of which <br />was duly filed of record as indicated, is continued, terminated, <br />partially released, or subordinated, to the extent indicated below. <br />Please Do Not Write In This Space <br />Nebraska ID Number <br />97956716 <br />Federal ID Number <br />Social Security Number <br />XXX -XX -4796 <br />Spouse's Social Security Number <br />Lien Serial Number <br />11293546 <br />Lien Filed With <br />Secretary of State, Register of Deeds <br />Date of Lten <br />08/15/2012 <br />Tax Program <br />22 <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />I <br />CARLOS BERMUDEZ <br />122 N GRACE AVENUE <br />GRAND ISLAND NE 68803 <br />Tax Years 2008 <br />UCC Instrument Number 99126975659 <br />County Instrument Number 201206818 <br />Type of Action <br />® Continuation of Tar <br />Lien <br />This is a continuation of an existing lien and serves to continue the lien and priority of the Nebraska Department of Revenue <br />for an additional 10 years. <br />1 hereby certify That the Nebraska Department of Revenue has complied with the laws or the State 01 Nebraska In determination of the <br />continuation, termination, partial release. or subordination indicated above. <br />Revenue Agent 01/11/2022 (402)471-0987 <br />►Preparers Signature Dee Date Phone Number <br />thao tang©nebraska gov <br />Revenue Supervisor <br />Title <br />01/1112022 <br />Date <br />4792-190e Ren. e-xole <br />Supersedes 4292.1t0 Rev. 1-2015 <br />